| NPI | 1700937422 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AR P1509102) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: AR A0203002) |
| 106H00000X Marriage & Family Therapist (Licence: AR M0501002) | |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2018-03-17 |